Upper Airway Computed Tomograph Findings Associated With Sleep Apnea

Objectives: The aim of this study was to determine whether alterations in anatomical structures and/or function of upper airway are present in patients with Obstructive or Central Sleep Apnea
Methods: Upper airway computed tomography (UACT) and polysomnography were performed on 370 adult individuals from Bogotá (Colombia). Informed consent was obtained from all individuals according to a protocol approved by the Ethical Committee of faculty of Medicine of Pontificia Universidad Javeriana and Hospital Universitario San Ignacio. Individuals were divided into three groups following polisomnography: non-apneic control group (112 individuals; apnea-hypopnea index (AHI)<5 events/hr), Obstructive Sleep Apnea (OSA) group (215-individuals; AHI≥15 events/hr) and Central Sleep Apnea (CSA) group (43-individuals; AHI≥15 events/hr). The structures evaluated by UACT included: airway length, laryngopharynx length, mandibular plane to hyoid distance, uvula size, uvula morphology, minimum lateral dimension of the retroglossal airway, retropalatal anteroposterior/lateral dimension, retroglossal anteroposterior/lateral dimension and ANB angle. To adequately evaluate airway function, all UACT measurements were taken in individuals during sleep and wakefulness. Associations between Sleep Apnea and alterations in upper airway structure and/or function were analyzed by Chi-square test.
Results: Both OSA and CSA showed statistically significant associations with septum deviation (p=0.026), uvula size (p=0.03), uvula morphology (p=0.032), mandibular plane to hyoid distance (p=0,06) and ANB angle (Class I associated to OSA, p=0.023). The comparison of minimum lateral dimension of the retroglossal airway, retropalatal anteroposterior/lateral dimension and retroglossal anteroposterior/lateral dimension did not show statistically significant differences when were compared during sleep and wakefulness.
Conclusions: Our results suggest that airway anatomy/collapsibility is associated to sleep apnea in adults and these alterations can be identified using these UACT measurements.